St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR

Professional

Both

$665.14

Service Code	HCPCS 93660
Min. Negotiated Rate	$498.86
Max. Negotiated Rate	$498.86
Rate for Payer: Cash Price	$184.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$498.86
Rate for Payer: SOMOS Essential	$498.86

PR CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR

Professional

Both

$358.09

Service Code	HCPCS 93660 26
Min. Negotiated Rate	$268.57
Max. Negotiated Rate	$268.57
Rate for Payer: Cash Price	$97.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$268.57
Rate for Payer: SOMOS Essential	$268.57

PR CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX

Professional

Both

$1,067.12

Service Code	HCPCS 92961
Min. Negotiated Rate	$800.34
Max. Negotiated Rate	$800.34
Rate for Payer: Cash Price	$284.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$800.34
Rate for Payer: SOMOS Essential	$800.34

PR CARDIOVERSION, ELECTIVE;EXTERN

Professional

Both

$443.63

Service Code	HCPCS 92960
Min. Negotiated Rate	$332.72
Max. Negotiated Rate	$332.72
Rate for Payer: Cash Price	$119.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$332.72
Rate for Payer: SOMOS Essential	$332.72

PR CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM

Professional

Both

$11.52

Service Code	HCPCS 96161
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$8.64
Rate for Payer: Cash Price	$3.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.64
Rate for Payer: SOMOS Essential	$8.64

PR CARE MANAGE BEH SVS 20MINS

Professional

Both

$117.53

Service Code	HCPCS G0323
Min. Negotiated Rate	$88.15
Max. Negotiated Rate	$88.15
Rate for Payer: Cash Price	$48.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$88.15
Rate for Payer: SOMOS Essential	$88.15

PR CARE MANAG H VST NEW PT 20 M

Professional

Both

$194.95

Service Code	HCPCS G0076
Min. Negotiated Rate	$146.21
Max. Negotiated Rate	$146.21
Rate for Payer: Cash Price	$54.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$146.21
Rate for Payer: SOMOS Essential	$146.21

PR CARE MANAG H VST NEW PT 30 M

Professional

Both

$294.21

Service Code	HCPCS G0077
Min. Negotiated Rate	$220.66
Max. Negotiated Rate	$220.66
Rate for Payer: Cash Price	$81.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$220.66
Rate for Payer: SOMOS Essential	$220.66

PR CARE MANAG H VST NEW PT 45 M

Professional

Both

$486.26

Service Code	HCPCS G0078
Min. Negotiated Rate	$364.70
Max. Negotiated Rate	$364.70
Rate for Payer: Cash Price	$133.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$364.70
Rate for Payer: SOMOS Essential	$364.70

PR CARE MANAG H VST NEW PT 60 M

Professional

Both

$645.09

Service Code	HCPCS G0079
Min. Negotiated Rate	$483.82
Max. Negotiated Rate	$483.82
Rate for Payer: Cash Price	$175.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$483.82
Rate for Payer: SOMOS Essential	$483.82

PR CARE MANAG H VST NEW PT 75 M

Professional

Both

$846.62

Service Code	HCPCS G0080
Min. Negotiated Rate	$634.96
Max. Negotiated Rate	$634.96
Rate for Payer: Cash Price	$232.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$634.96
Rate for Payer: SOMOS Essential	$634.96

PR CARE MAN HOME CARE PLAN 30 M

Professional

Both

$308.98

Service Code	HCPCS G0086
Min. Negotiated Rate	$231.74
Max. Negotiated Rate	$231.74
Rate for Payer: Cash Price	$84.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$231.74
Rate for Payer: SOMOS Essential	$231.74

PR CARE MAN HOME CARE PLAN 60 M

Professional

Both

$430.50

Service Code	HCPCS G0087
Min. Negotiated Rate	$322.88
Max. Negotiated Rate	$322.88
Rate for Payer: Cash Price	$117.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$322.88
Rate for Payer: SOMOS Essential	$322.88

PR CARE MAN H V EXT PT 20 MI

Professional

Both

$190.82

Service Code	HCPCS G0081
Min. Negotiated Rate	$143.12
Max. Negotiated Rate	$143.12
Rate for Payer: Cash Price	$53.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$143.12
Rate for Payer: SOMOS Essential	$143.12

PR CARE MAN H V EXT PT 30 M

Professional

Both

$313.60

Service Code	HCPCS G0082
Min. Negotiated Rate	$235.20
Max. Negotiated Rate	$235.20
Rate for Payer: Cash Price	$86.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$235.20
Rate for Payer: SOMOS Essential	$235.20

PR CARE MAN H V EXT PT 45 M

Professional

Both

$505.09

Service Code	HCPCS G0083
Min. Negotiated Rate	$378.82
Max. Negotiated Rate	$378.82
Rate for Payer: Cash Price	$138.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$378.82
Rate for Payer: SOMOS Essential	$378.82

PR CARE MAN H V EXT PT 60 M

Professional

Both

$716.42

Service Code	HCPCS G0084
Min. Negotiated Rate	$537.32
Max. Negotiated Rate	$537.32
Rate for Payer: Cash Price	$195.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$537.32
Rate for Payer: SOMOS Essential	$537.32

PR CARE MAN H V EXT PT 75 M

Professional

Both

$846.62

Service Code	HCPCS G0085
Min. Negotiated Rate	$634.96
Max. Negotiated Rate	$634.96
Rate for Payer: Cash Price	$232.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$634.96
Rate for Payer: SOMOS Essential	$634.96

PR CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS

Professional

Both

$118.97

Service Code	HCPCS 99484
Min. Negotiated Rate	$89.23
Max. Negotiated Rate	$89.23
Rate for Payer: Cash Price	$48.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$89.23
Rate for Payer: SOMOS Essential	$89.23

PR CARINAL RECONSTRUCTION

Professional

Both

$7,907.38

Service Code	HCPCS 31766
Min. Negotiated Rate	$5,930.54
Max. Negotiated Rate	$5,930.54
Rate for Payer: Cash Price	$2,102.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,930.54
Rate for Payer: SOMOS Essential	$5,930.54

PR CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT

Professional

Both

$271.81

Service Code	HCPCS 93598 26
Min. Negotiated Rate	$203.86
Max. Negotiated Rate	$203.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$203.86
Rate for Payer: SOMOS Essential	$203.86

PR CARPECTOMY 1 BONE

Professional

Both

$2,185.44

Service Code	HCPCS 25210
Min. Negotiated Rate	$1,639.08
Max. Negotiated Rate	$1,639.08
Rate for Payer: Cash Price	$595.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,639.08
Rate for Payer: SOMOS Essential	$1,639.08

PR CARPECTOMY ALL BONES PROXIMAL ROW

Professional

Both

$2,740.82

Service Code	HCPCS 25215
Min. Negotiated Rate	$2,055.62
Max. Negotiated Rate	$2,055.62
Rate for Payer: Cash Price	$743.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,055.62
Rate for Payer: SOMOS Essential	$2,055.62

PR CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN

Professional

Both

$96.95

Service Code	HCPCS 94780
Min. Negotiated Rate	$72.71
Max. Negotiated Rate	$72.71
Rate for Payer: Cash Price	$25.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$72.71
Rate for Payer: SOMOS Essential	$72.71

PR CAR SEAT/BED TEST INFT THRU 12 MO EA ADDL 30 MIN

Professional

Both

$32.66

Service Code	HCPCS 94781
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Cash Price	$8.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24.50
Rate for Payer: SOMOS Essential	$24.50

Know your out-of-pocket cost for care.

All Charges